Jiang Saizhi, Hu Qingqing, Zhang Jing
Department of Pediatrics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Front Pediatr. 2022 Dec 8;10:1023798. doi: 10.3389/fped.2022.1023798. eCollection 2022.
Glucocorticoids are currently used for the co-therapeutic management of autoimmune hepatitis and some cholestatic diseases. Thus far, we do not know the efficacy of glucocorticoids in the treatment of parenteral nutrition-associated cholestasis. We aimed to analyze whether the administration of late postnatal dexamethasone for treating bronchopulmonary dysplasia influence the occurrence of parenteral nutrition-associated cholestasis in preterm neonates.
A retrospective study was conducted for 78 preterm neonates without major anomalies (gestational age was <30 weeks, and birthweight was ≤1000 g) hospitalized in a neonatal unit. Total and direct serum bilirubin levels were measured about every two weeks for all neonates. Data including the administration of dexamethasone, intravenous nutrition, and enteral feeding were collected by at least three audits.
A total of 15 preterm neonates were diagnosed with parenteral nutrition-associated cholestasis, and after stopping parenteral nutrition, the direct bilirubin value decreased to the normal level for no longer than 150 days. The prolonged duration of parenteral nutrition was a risk factor, and late postnatal dexamethasone treatment was a protective factor in reducing the incidence of parenteral nutrition-associated cholestasis.
Dexamethasone treatment may reduce the occurrence of parenteral nutrition-associated cholestasis in preterm neonates.
糖皮质激素目前用于自身免疫性肝炎和某些胆汁淤积性疾病的联合治疗管理。到目前为止，我们尚不清楚糖皮质激素在治疗肠外营养相关性胆汁淤积中的疗效。我们旨在分析出生后晚期给予地塞米松治疗支气管肺发育不良是否会影响早产儿肠外营养相关性胆汁淤积的发生。
对一家新生儿病房收治的78例无重大畸形的早产儿（胎龄<30周，出生体重≤1000g）进行回顾性研究。所有新生儿大约每两周测量一次血清总胆红素和直接胆红素水平。通过至少三次审核收集包括地塞米松给药、静脉营养和肠内喂养的数据。
共有15例早产儿被诊断为肠外营养相关性胆汁淤积，停止肠外营养后，直接胆红素值降至正常水平的时间不超过150天。肠外营养持续时间延长是一个危险因素，出生后晚期地塞米松治疗是降低肠外营养相关性胆汁淤积发生率的一个保护因素。
地塞米松治疗可能会降低早产儿肠外营养相关性胆汁淤积的发生。
